A look at the numbers

Coverage declinesThe headline number is that by 2026, 24 million fewer people will have health insurance coverage under the American Health Care Act than would be covered under current law, i.e., the Affordable Care Act. As soon as 2018, 14 million more people would be uninsured, largely stemming from the repeal of the individual mandate.

Medicaid cutsThe plan cuts Medicaid outlays by a remarkable US$880 billion over 10 years, reducing its federal support by 25 percent in 2026. Compared to the ACA, the cuts would knock 14 million people off Medicaid by 2026, most of whom would likely end up uninsured. The plan functionally ends the ACA’s Medicaid expansion in 2020.

Deficit reductionThe bill would reduce deficits by about US$340 billion over the next decade. The deficit reduction is the net result of US$1.2 trillion in spending cuts (including the Medicaid cuts noted above) offset by US$883 billion in revenue losses from tax cuts. Though CBO does not discuss who benefits from these tax cuts, Center on Budget analysis shows that because the taxes that support the ACA are highly progressive, repealing them mostly benefits the wealthiest households and businesses.

Changes in premium tax creditsOlder, low and moderate income persons who buy coverage in the non-group market would pay more out of pocket under the AHCA. Conversely, higher income individuals would pay less for nongroup coverage.